Resident Doctors: Industrial Action

12:15:00

With your permission, Madam Deputy Speaker, I will make a statement on planned industrial action by resident doctors. Today’s waiting list figures show that after 14 years of decline, the NHS is finally moving in the right direction. Since July, we have cut waiting lists by 260,000. We promised to deliver an extra 2 million appointments in our first year, and have more than doubled that figure, delivering 4.6 million more appointments. For the first time in 17 years, waiting lists fell in the month of May, and they now stand at their lowest level in more than two years. That is what can happen when NHS staff and a Labour Government work together. We have put the NHS on the road to recovery, but we all know that it is still hanging by a thread, and that the BMA is threatening to pull that thread. On Tuesday this week, I met the co-chairs of the BMA’s resident doctors committee to discuss the results of its ballot for industrial action. In that meeting, and in a letter I sent yesterday, I offered to meet the BMA’s full resident doctors committee and work with it to improve its members’ working lives. Since the start of this year, I have offered repeatedly to meet the entire committee, but it still has not taken up my offer. Instead of agreeing to talk, the BMA responded by announcing five days of strike action. Its planned strike action will run from 7 am on Friday 25 July to 7 am on Wednesday 30 July. These strikes are unnecessary, given this Government’s willingness and eagerness to work together to improve resident doctors’ working conditions. Following a 28.9% pay rise thanks to the actions of this Government, the BMA’s threatened industrial action is entirely unreasonable. I am asking it again today to pause, call off the strikes, and instead work with the Government to rebuild its members’ working conditions and rebuild our NHS. Before this Government came into office, a toxic combination of Conservative mismanagement and strikes was crippling the NHS. The cost to the NHS ran to £1.7 billion in just one year; patients saw 1.5 million operations and appointments cancelled, and people’s lives were ruined. Phoebe suffers from a genetic condition: neurofibromatosis, which causes non-cancerous tumours on the outside of her body. Her first operation at Great Ormond Street hospital was cancelled twice—at first due to strikes, and then because there was not the capacity to treat her. Phoebe loves going to school, and it is an absolute tragedy that her education was set back. She was prevented from doing what she loves because the NHS was not there for her when she needed it, but this year, when Phoebe’s family contacted Great Ormond Street in March, her surgery was scheduled less than two weeks later. Compared with what she went through two years ago, the difference was night and day. That is the difference a Labour Government make, and it is why this Government were absolutely right to end the strikes when we came to office. I am so proud of what we have achieved together with NHS staff. In the words of one NHS leader I spoke to recently, there is light at the end of the tunnel and, for the first time, it is not an oncoming train. That has only been possible because of the deal this Government negotiated. When we agreed that deal to end the strikes last year, resident doctors did not just receive a 22% pay rise; the Government also gave a genuine commitment to build a new partnership with those we now call resident doctors, based on mutual respect. I have personally ensured that that commitment was followed through. A new exception reporting process has been agreed with resident doctors in principle, so that doctors are paid for the work they are asked to do. A review of rotational training is under way and almost complete to reduce disruption to resident doctors’ lives. We promised to tackle GP unemployment, and we have delivered with an extra 1,900 GPs on the frontline who were otherwise facing unemployment. I am determined to go further to tackle doctor unemployment. When I say to resident doctors that I want to tackle the bottlenecks they face, and the unfair competition for specialty training places, and to create more training places, they can judge me not just by my words, but by my actions. When the pay review body recommended a 5.4% average pay rise for resident doctors this year, we accepted that and funded it in full. Those are not grounds for industrial action. Indeed, in the history of British trade unions, it is completely unprecedented for a pay rise of 28.9% to be met with strikes. The BMA itself described this pay rise as “generous”. Thanks to this Government, the average annual earnings per first year resident doctor last year were £43,275. That is significantly more, in a resident doctor’s first year, than the average full-time worker in this country, and it is set to increase further with this year’s pay award. For resident doctors in their second year out of medical school, their average annual earnings rose to £52,300 last year. In core training years, resident doctors earned an average of £67,000. Specialty registrars earned on average almost £75,000. There is no question but that these are highly trained, highly skilled medics who work hard for their money, but to threaten strikes in these circumstances is unreasonable and unnecessary, so it is no wonder that the BMA has lost the public’s support. At the beginning of this dispute, resident doctors faced a Conservative Government cutting their pay and refusing to talk to them. A clear majority supported action as a result. In February 2023, 56% of the public backed junior doctor strikes. Today, that support has collapsed. Just one in five people believe that the BMA is doing the right thing. Patients are begging resident doctors not to walk out on them, and I hope the BMA is listening, because many resident doctors are. For the first time since the BMA’s campaign began, a majority of BMA resident doctors did not vote for strike action. They can see that the Government have changed and our approach has changed, yet the BMA’s tactics have not. Resident doctors have received the highest pay award in the public sector, both this year and last year, so renegotiating this year’s pay award would be deeply unfair to all other public servants. Such a deal would be paid for by their future earnings, and with the greatest respect to resident doctors, there are people working in our public services who are feeling the pinch more than they are. Even if it would not be unfair on public sector workers, it is unaffordable. It should be apparent to anyone that the public finances this Government inherited are not awash with cash, so I will not and cannot negotiate on this year’s pay award, and I am not going to lead resident doctors up the garden path by making promises unless I know I can keep them. As I have said in person, in writing, in private and in public, I am willing and ready to get around the table and work together to improve the working conditions of resident doctors. There is so much more that we can do together. I do not just hear the complaints that resident doctors have about their placements, rotations and bottlenecks— I agree with them. I know the NHS has been a bad employer, and I am determined to change it. My offer to talk comes with no preconditions attached. I will also say this to resident doctors directly: consider very carefully the consequences of your actions.

Order. May I suggest to the Secretary of State that his statement has already taken 10 minutes and he has not asked for additional time? Does he wish to consider whether his statement is to the House, or to those outside the House? He might like to make a few closing remarks.

Thank you, Madam Deputy Speaker. I will move to closing. I did share the statement in advance, including with Opposition parties and the Speaker’s Office. I just say to resident doctors, and it is important that the House knows what we are saying to them, that they should carefully consider the consequences of their actions. Five days of strike action mean patients and their families receiving the phone call they are currently dreading, being told that the operation or appointment they have been waiting for—often for far too long—is being cancelled and delayed. I know how I would feel if that happened to a member of my family, and I ask them to consider how they would feel if that happened to a member of theirs. While they are out on the picket line, protesting the 28.9% pay increase they have had, their friends and colleagues and other NHS staff—many of whom are paid less and receive less than them—will be inside, picking up the pieces and working in harder conditions to cover for the consequences of resident doctors’ actions. In conclusion, the strikes are not only unnecessary and unreasonable, but unfair. They are unfair on patients, unfair on other NHS staff, and unfair to the future of the NHS, which is in jeopardy. The tragedy is that they will never have had a Secretary of State as sympathetic to their legitimate complaints as this one. If they want to know what the alternative is, its Members are not sat here. They have not even bothered to show up today, and that party does not even believe in the NHS. The grass is not greener on the other side. I ask them not to squander this opportunity. At this stage, we can still come out of this dispute with a win for the BMA’s members, a win for the NHS and a win for patients, but if the BMA continues down the path of strike action, it will lose its campaign, resident doctors will be worse off, and the heaviest price of all will be paid by patients. I commend this statement to the House.

I call the shadow Secretary of State.

12:27:00

I am grateful to the Secretary of State for his typical courtesy and advance sight of his statement. I also note that he is among the most assiduous of Ministers in volunteering himself to this House to be questioned on issues of importance. I am, however, afraid it comes as no surprise that we are here today discussing likely industrial action on this Government’s watch. Last year, we warned the Government that caving in to union demands for above-inflation pay rises without any conditions or strings attached would set a dangerous precedent. It would send a message that the Government were weak, and we warned that the unions would simply come back for more. Unfortunately, events in recent days have shown that we were right. The public will be understandably concerned about what this industrial action will mean for them and the provision of local NHS services. For patients with an appointment scheduled or even on a waiting list, that concern will be particularly acute. Let me be clear: this BMA strike action—as the Secretary of State has said, it is supported by less than 50% of those eligible to vote—is irresponsible, wrong and unnecessary. On that, I agree with the Secretary of State. Will the Secretary of State enlarge on the additional steps that he is taking to seek to resolve the industrial dispute and prevent the strike action from going ahead? I heard what he said about his willingness to talk. Does he anticipate further meetings before strikes start on 25 July, and does he anticipate a risk of any other parts of the NHS workforce balloting for strike action? If this strike action does take place, what steps are being put in place to minimise disruption, what is the plan to protect patients who will need to access NHS services over this period, and can the Secretary of State guarantee that emergency cover will remain and that there will be minimum service levels in place? More broadly, and based on the previous strikes, how many appointments do the Government anticipate are at risk of being cancelled or postponed, and has he assessed what impact the decision by the BMA will have on his aim of reducing waiting lists and meeting his 18-week target? The previous chief financial officer of NHS England said that nearly all the money allocated to the NHS at the autumn Budget will be eaten up by NHS pay settlements, the national insurance hike and increased inflationary costs, just to maintain services at their existing level. Following the recent spending review and the Chancellor’s announcement of additional funding, how much of that does the Secretary of State anticipate will be spent on staffing costs, including the already agreed pay award and the national insurance increase, and how much of it will actually make it to the frontline in the form of additional care, or to fund the reforms that he set out recently? What does the Secretary of State anticipate will be the long-lasting impact of strike action on relations between the Government and trade unions in the health space? The 10-year plan was published just last week. As I said at the time, it is sensible and I am supportive of what he has set out in that, but concerns have been raised about its deliverability. The Secretary of State has said previously that he will need to work with the unions to deliver on the plan. Is he still confident that that will be possible? Does he believe that they will agree to the changes that are required, or is there a risk of further strike action over the coming years because doctors have sensed a weakness? In opposition, the Secretary of State had some very strong and well-articulated views on industrial action. He said strike action was “playing politics with our NHS”. On that, I agree with him. He said that “the Government ought to be pulling out all the stops”—[Official Report, 22 December 2022; Vol. 724, c. 218.] and that “the power to stop these strikes is in the Government’s hands.”—[Official Report, 12 December 2022; Vol. 724, c. 732.] He is the Secretary of State now. Does he agree that the power to stop these strikes is in his hands? Our message to the Government is clear. The Secretary of State needs to do what he has said he will do: face down union pressure and deliver an affordable settlement that is fair to staff, patients and, crucially, taxpayers. On his watch, resident doctors are set to leave the frontline to go on to the picket line—whether that happens will be down to him. Sadly, Labour’s weakness is fuelling this crisis. If the Government do not get a grip now, a summer of discontent and strikes risks turning into a summer of chaos, and it will be patients who pay the price.

I think the shadow Secretary of State’s memory is letting him down. Let me just remind him that before the general election, and after months of refusing to meet the BMA, the Conservatives finally entered negotiations, but not before strikes were left to run and run—at a cost of £1.7 billion to the taxpayer—and 1.5 million operations, appointments and procedures were cancelled. They also offered the BMA junior doctors a pay rise, which was only about 4% of the pay rise that we eventually agreed. Imagine what would have happened if the Conservatives had pulled their finger out and got the doctors around the table sooner, and had not been quite so intransigent. The shadow Secretary of State is right to say that I criticised my predecessors for their unwillingness to negotiate. The difference between me and them is that I have acted. Resident doctors have had a 28.9% pay increase thanks to the decisions that I have taken as Secretary of State, with the support of the entire Government. They have a Secretary of State who does not slam the door in their face, but who is open to working with them to improve their conditions. The responsibility for these strikes lies squarely with those running the BMA’s resident doctors committee. Despite failing to get a majority of their members to vote for strike action for the first time in their campaign, they are still proposing to lead their members out on a five-day strike. They even made the announcement on the day that I had already written to them to suggest that we meet to avert unnecessary strike action. The shadow Secretary of State is right to talk about the jeopardy facing the future. Because we produced our 10-year plan in partnership with patients, the public and NHS staff, there is not only much in it that resident doctors should welcome, but much that they suggested. Our 10-year workforce plan will set out training, education and retention of the workforce, and we will work closely with resident doctors on standards. They should start to experience an improvement in their working conditions on everything from the availability of nutritious food and drink to reducing violence against staff and tackling discrimination. We have already committed to prioritise UK graduates for training, and we have started a conversation on contractual reform with trade unions across the board. We are determined to recruit more people locally and to tackle social disadvantage, access to medicine and all the issues that are at the forefront of the minds of resident doctors, such as placements, rotations and future career progression, including specialty bottlenecks. I absolutely want to work with them. These are not conditions for strikes. These are conditions to work in partnership with the Government, just as other NHS unions and so many other trade unions across the public sector do. I say to resident doctors once more that sitting in front of me is the ghost of Christmas past. Reform—its Members are not in their place today—is the ghost of Christmas future. Perhaps BMA members might consider that they are lucky to have the ghost of Christmas present in front of them.

I am glad the Secretary of State has reminded Conservative Members that they have rather short-term memories. When I took my place in this House last year, thousands of my residents in Gloucester were on NHS waiting lists—many of them for longer than 18 months. Since this Labour Government took power last year, the number has come down by 92%, in part thanks to the hard work of resident doctors in my constituency. Does the Secretary of State agree that strike action by the BMA will put that recovery at risk? Will he invite its members to meet my residents who are still on the waiting lists left behind by the Conservative party, so that they can explain why the 28.9% pay rise, which many of my constituents will not receive this year, is not enough?

I completely agree with my hon. Friend. I urge BMA members to consider not just the significant progress that they have already made by working with a Labour Government, but the wider context in which we are operating. It is not just resident doctors who have seen their pay eroded over more than a decade of Conservative Government; it is the entire public sector. It is not just resident doctors who are working in crumbling buildings with out-of-date equipment and technology; it is the same in our schools, our hospitals, our prisons and the entire public sector estate. This Government are facing enormous challenges across our economy, and we cannot sort out every issue that we inherited overnight, or even in one year—it is going to take time. BMA members should be proud of the progress that we have made together, and reassured that we want to make further progress with them, but there has to be some give and take here, and there has to be some reasonableness. Given the potential consequences of their action for patients, for their fellow staff and for the future of the NHS, the strike action is unreasonable, unnecessary and deeply unfair.

I call the Liberal Democrat spokesperson.

People across the country, and NHS patients in particular, will be disappointed to hear of yet more strike action by resident doctors this July, especially after the immense disruption of recent years. I and my Liberal Democrat colleagues fully recognise that this dispute does not come out of nowhere. The previous conservative Government left our NHS under unbearable strain, with doctors working under intense pressure in crumbling hospitals and often without the resources they needed. My constituents, and people across the country, need and deserve a well-functioning NHS. Over the past three years, doctors have received a 28.9% pay rise following earlier strikes. The BMA is now calling for a further 29% increase, but we have to be honest: after years of economic mismanagement by the Conservatives, the public finances are in a dire state. That kind of increase does not feel affordable or realistic right now. That said, we cannot ignore the reality of working conditions in our NHS. Doctors are expected to save lives in collapsing wards and to deliver care in corridors, rather than in safe clinical settings. It is degrading and dangerous for both staff and patients. We need constructive dialogue, not escalation, to resolve this dispute swiftly and fairly, and most importantly, we need urgent action to rebuild our NHS and restore working conditions that our doctors and patients can be proud of. First, will the Secretary of State improve staff morale by committing to end the dangerous and dehumanising practice of corridor care? Secondly, does he not see that by dragging out social care reform, delayed discharges and corridor care are only going to worsen doctors’ experiences of working in the NHS, weakening morale and lowering care standards?

I am grateful to the Liberal Democrat spokesperson, and I think I can reassure her on a number of fronts. First, she is absolutely right to call out the disgrace that is corridor care. Despite the best efforts of staff, who suffer the moral injury of treating patients in that situation, in too many parts of the NHS we have patients being treated on trolleys in corridors. In this decade of the 21st century, I think that is unacceptable, as is the emerging nomenclature that has started to describe these as “temporary escalation spaces”, because we are in danger of normalising what should be considered unacceptable practice. That is why this Government will shortly begin transparently publishing corridor care data showing the number of patients being treated on trolleys in corridors. I am sure there will be moments when that might cause Ministers and NHS leaders to blush, but frankly, until corridor care is consigned to history, so we should. Sunlight is the best disinfectant, and by publishing the data we will hold ourselves to account, and I am sure this House will hold us to account to ensure that we deliver the conditions that staff and patients deserve. I also reassure the hon. Member that, while the Casey commission is under way, work on social care goes on, whether that is the £4 billion increase in investment in social care through the decisions taken by my right hon. Friend the Chancellor, or other improvements such as to carer’s allowance, the disabled facilities grant and uplifts in funding for local authorities. However, I am also committed to ensuring that, as we improve the flow of patients through our hospitals and deal with the scourge of delayed discharges, we are a lot better at thinking about how we use the taxpayer pound to best effect to deliver the right care, in the right place and at the right time. That will often mean using NHS resources to commission social care to help tackle delayed discharges, and we will be keeping a close eye on that. Finally, I thank the hon. Member for joining the voices of reason in this Chamber. I hope it is not lost on the BMA and resident doctors watching that this is not a case of an intransigent Government unwilling to work with and support them who are trying to face down, for political and ideological purposes, a trade union speaking up for its members. This Labour Government have delivered a 28.9% pay increase and we are willing to work further to improve conditions for resident doctors. That work can start now, and I am ready to meet the BMA immediately. There are other voices of reason in this Chamber, including among the Liberal Democrats, who recognise the pressure on the public finances. They recognise that we are trying to do many things across the NHS that will also directly benefit resident doctors, such as making sure they have the right kit and are working in decent buildings. We are improving the conditions that they are working in and that patients are treated in so that, together, we are building in, working in and being treated in an improving NHS. That is the prize, and that prize is being thrown into jeopardy by the resident doctors’ actions. If they go down this path, with all of the consequences that will follow, I am afraid—for them, let alone for the NHS and for the country—things will get worse rather than better, and I urge them not to take that course of action.

Does my right hon. Friend agree that we were right to settle the strikes last year, for the sake of ensuring the future of the NHS, protecting the interests of the public and showing our doctors that they are valued, that that will always be his position, and that it is therefore somewhat surprising that resident doctors have decided to call this strike?

I strongly agree with my hon. Friend—he is absolutely right. I am happy to stand corrected, but there is genuinely no historical precedent in the history of British trade unionism for a trade union to have successfully negotiated with the Government of the day a 28.9% increase for its members and then go out on strike. I think that undermines the BMA, and the more reasonable voices in the BMA with whom we continue to work constructively. It certainly undermines our NHS. It also reinforces the grossly unfair caricature, which is often thrown at trade unions by the Conservatives, that they are all unreasonable, do not want to work with the Government of the day and are only interested in combat and agitation. In my experience, the vast majority of trade unions and trade unionists are interested in constructive engagement, striking good deals and moving forward the interests not just of their members, but of our whole country. I urge the BMA resident doctors committee to stand in that proud tradition of British trade unionism and in the proud traditions of the wider Labour movement, but I am afraid I do not see those traditions or behaviours reflected in the current approach of the BMA RDC.

We can all argue about the past, but if it helps the Secretary of State, I think we should just say today that the whole House absolutely 100% supports him in his robust attitude. [Hon. Members: “Hear, hear.”] Of course we all love doctors, but the starting salary is not so very bad. They have a job—a very good job—for life, which most people do not have, and he could also mention that they have a much better career structure than most people. A far higher proportion of them get the top job—namely, as a consultant—and the consultant’s starting salary of £110,000 a year is not a bad whack.

First, I think that the right hon. Member’s opening statement and the response across the House underline to the BMA and the resident doctors committee that they do not have support across this House—from the left across to the right, with maybe one or two noises off—and that is not typical in my experience of being in this House for the last decade. I think the career of resident doctors and the prospects they can look forward to, which the right hon. Member described, have worsened. That is one of the things that is at the heart of the dispute they have taken up with the previous Government and now with this one. Many of the things doctors used to be able to look forward to—guaranteed jobs and progression into consultant roles or general practice—have steadily eroded. We have far too much doctor unemployment and far too many specialty bottlenecks. We have what I think is a really unreasonable set of behaviours towards resident doctors in terms of placements, rotations and the ability to take time off work to attend weddings and other important life moments. The tragedy of the position we find ourselves in is that I recognise that and I want to address it. We can do that together without the need for strike action, and those are not reasons for strikes. Worse still, especially at a time when I am prioritising dealing with doctor unemployment, they are inflicting further costs on the NHS, patients and the taxpayer. That makes my freedom and flexibility and my resources to deal with those issues more limited—that is the tragedy of their tactics.

I thank the Secretary of State for his statement and the ongoing work to get the NHS back on its feet after it was pushed to the brink under the previous Government. Strikes inevitably have a financial and a human cost to them, and the next round of strikes will undoubtedly have that too, meaning that the NHS will take a financial hit. Can he share the impact that this will have on the system? For example, can he guarantee that the cost of these strikes will not lead to job cuts?

In all honesty, I am afraid I cannot give my hon. Friend that assurance. NHS finances are precariously balanced. We have been relative winners across the Budget and the spending review set out by my right hon. Friend the Chancellor of the Exchequer, but we are asking a lot of the system. As well as the progress and improvements we want in the NHS, we inherited a lot of mess to clean up, and that will take time and resource. Every penny spent on the price of failure through strike action is a penny that could have been spent on driving improvements in the service—improvements for patients and for staff—and on creating the jobs and opportunities that mean doctors do not graduate into unemployment and that mean resident doctors can progress into specialty training posts. That is why I say clearly and unequivocally to the BMA that if this strike action goes ahead, with all the costs, pain and misery that will follow, it will not just be patients—or, indeed, this Government—who suffer, but the BMA.

I have known the Secretary of State a long time. I knew him before he was an important man—although he was always important to me, of course. He will know that as a Minister, I worked with the trade unions in every sector for which I was responsible, as the RMT and the University and College Union will confirm, and I was also a member of the Association of Teachers and Lecturers. I entirely endorse and amplify what he says. Responsible trade unionism requires people to be reasonable, and reasonable people in this House know that this strike against this background is entirely unacceptable, as he has described. I ask the Secretary of State this: will he ensure that this unhappy, unwholesome and unhealthy action does not jeopardise the health of my constituents, and will he write to the local authorities—the integrated care boards—in my area and others to set out how they can minimise the impact of this action? The last thing that you want, Madam Deputy Speaker, or that I or any Member across this House wants, is for those at risk to be put at greater risk as a result of this irresponsible action by these militant people.

I thank the right hon. Gentleman for his question. He is that rare beast: a Tory trade unionist. He raises the serious point of the consequences of strike action. I will, of course, keep the House updated, but I want to reassure the House that we are taking every step possible to mitigate the disruption that these strikes will cause. That will come at a financial cost and a cost to patients because of the disruption that will follow. It will also come at a cost to other staff, many of whom are paid less than resident doctors, who will be left at work with more pressure and in harder conditions, picking up the pieces because of the actions of their colleagues who were given a higher pay rise, but who will be stood outside protesting the 28.9% pay rise that they received. I assure the House that we will do everything we can to mitigate the impact of the strikes on patients and the disruption that will follow. What I cannot say to the House, however, is that we can offset or cancel the impact or detriment felt by patients. We will look carefully at the data on the experience and impact of the strikes that occurred during the previous round of negotiations. I will ensure that that information is published so that the House can see the impact of the previous strikes, so that we can brace ourselves for what may lie ahead.

Anyone who has ever worked in healthcare knows that it is a team sport and that delivering excellent care requires a range of staff across the allied health professions including nurses, doctors, administrative staff and estate staff. Does the Secretary of State agree that it is therefore essential that all NHS staff groups have confidence that their pay is being set fairly, and that going beyond the independent pay review body’s recommendations for one set of staff would undermine the “one NHS” team ethos that so many have worked to build?

I strongly agree with what my hon. Friend says. I have been personally invested in our relationship with resident doctors and in the deal we struck—not just because it was one of the first things we did when we came into office, and because I am very proud of what we have achieved together, but because I had and still have a huge amount of support and sympathy for resident doctors and a determination to address the issues they are raising. However, I reassure my hon. Friend and the House that resident doctors are one part of the NHS workforce—a valued part—but I have responsibility for the entire workforce. We set ourselves the task of building an NHS fit for the future, but we cannot do it on our own as a Government; it requires the whole team to pull together. I will be honest with my hon. Friend: I feel a considerable degree of discomfort when I look back at a whole number of deals and pay awards, under this Government and our predecessors, where the “Agenda for Change” workforce have been left further behind. I will be honest with the House: at this moment, I have to resolve the immediate action that is being proposed by the BMA, but I am not going to allow the reform we have committed to with the “Agenda for Change” unions to be deprioritised —we owe that to them. We owe it to the nurses and to all the “Agenda for Change” staff to ensure that they are paid fairly, are given a fair day’s pay for a fair day’s work, and receive the terms and conditions that they deserve. My priority at this stage is the “Agenda for Change” reform. Of course, I will do everything I can to resolve the resident doctors strikes, but what I cannot do is reopen this year’s pay award.

I remind hon. Members and the Secretary of State that we have an important statement to come, as well as two Backbench Business debates. May we have short questions and shorter answers?

I agree with the Secretary of State when he tells the BMA resident doctors that they will never have another Secretary of State as sympathetic to their legitimate complaints— I recognise that, having worked with five of his predecessors. My experience tells me that what happens here with the BMA often filters through to the devolved nations. What engagement has he had with his counterparts on the proposed industrial action so that there can be a combined resolution and message to the BMA?

I reassure the hon. Gentleman that I will obviously engage with my counterparts in the devolved Administrations. While health is a devolved matter, the decisions that we take in this place, and what is going on in the English health system, have a bearing on other health systems, and vice versa. I am almost tempted to call back the right hon. Member for North East Cambridgeshire (Steve Barclay), who is still a Member of this House, to remind the BMA what it went up against twice before; indeed, I could call back any of my Conservative predecessors to remind the BMA that the grass is not greener on the other side of this House. It currently has a Secretary of State who has shown through actions, not just words, a willingness to work together, and I hope that it rediscovers the spirit of partnership that we had last year.

We all know how vital resident doctors are to the functioning of our national health service. In the light of that, will the Secretary of State join me in once again urging the BMA resident doctors committee to get back around the table to engage in serious talks and to take up his offer to meet in the interests of all NHS staff and patients, so that we can rebuild the national health service in the way the public expect?

Quite aside from the fact that I offered to meet the entire resident doctors committee back in January, although it has never taken me up on that offer—I would definitely be outnumbered in that meeting— I can reassure the House, in all seriousness, that I met its co-chairs on Tuesday afternoon, immediately after the publication of the ballot result. I followed up in writing yesterday morning to reaffirm what I said in person, which was to express our willingness to meet immediately, without preconditions, to avert this strike action. That offer remains, and I am very happy to meet them on that basis.

My wife has a long-term chronic health condition; she has had to have two major lifesaving surgeries, and has had countless stays in hospitals. We have seen the fantastic work that many doctors and consultants do, but we have also seen the impact it has when there are cancellations and delays, or when no doctors are available. Many people will have been flabbergasted by the sheer scale of the pay rise that was awarded in the first place, without anything in return to deliver the NHS reforms that the Government seek. Those people will now be absolutely outraged that the BMA is going on strike after having a near 30% pay increase. I plead with the Secretary of State to hold the line in these negotiations, and to take away the cross-party support he has in holding the line against the BMA on this issue.

We will not be reopening this year’s pay award because we simply cannot afford to, and it would not be fair on others in the NHS workforce, regardless. I honestly do not regret the deal that we struck last year, without which we would not have made the progress that we have on NHS waiting lists, which are now at their lowest level in two years. We have made that considerable progress by working together. I do not think that the staff themselves are the drain on productivity; instead, the obstacles we face are the systems and pathways in which staff work and the conditions in the NHS—we are in real agreement on those things. I urge the BMA to keep all that under consideration before its next public intervention, which I hope will be to accept the offer to get around the table to avert the strike action that I think the whole House agrees is unnecessary, unreasonable and unfair.

I thank my right hon. Friend for his statement, which was delivered with the humility and pragmatism that is his usual professional style. After a 28.9% pay rise thanks to this Labour Government, does the Secretary of State agree that the public are not only dismayed by the actions of the BMA, but distraught and that, once again, it will be the patients who will suffer the most by this action, which is so unnecessary at this particular moment?

I entirely agree with my hon. Friend. It will be patients who suffer the most. I also urge the BMA to consider the impact on its whole membership, because it is other staff who are left picking up the pieces, and other staff who are tired—literally tired—of working in an NHS that is far from its best. To resident doctors in particular, I say that the cost of this will also be borne by them. There are choices and trade-offs in politics, especially when resources are tight. We can and we will act to deal with specialty bottlenecks. We can and we will act to tackle doctor unemployment, but our ability to do so is undermined, if not diminished, if we are instead paying the cost of this unnecessary, unreasonable and unfair strike action.

I thank the Secretary of State for his statement today and fully support the line of action that he has taken. Indications that the majority of doctors in the BMA did not vote to strike makes this strike action even more difficult to understand. The Secretary of State is clearly trying to find a way forward. The way to do that is through finding solutions. Reviewing conditions of work, such as those that see junior doctors working 84 hours within the space of a week, would be helpful. Perhaps this action is not only about pay, but about the expectations of these young people who have life and death in their hands for 13 hours for six out of seven days a week.

The hon. Gentleman makes an entirely reasonable point. Pay is important—people have to be able to pay their bills and lead a good life—but so too are their working conditions. I am absolutely determined to work with resident doctors to make progress not just on pay, which we have already done, but on the conditions in which they are working. Given where we are with both of those things—the improvement on pay and the willingness to work together to improve conditions—they are not grounds for strike action.

I congratulate my right hon. Friend on showing great leadership when he came into office to get those doctors back to work and end the strikes. The result of that has been falling waiting times and waiting lists, and I have seen the benefit of that for my constituents in Shipley; they are not having to wait for operations and diagnostic tests in the NHS. Does he agree that this is no time for strike action, and that, should the BMA and the resident doctors go ahead with this strike, this will adversely affect patients and waiting times?

I entirely agree with my hon. Friend. Looking back at all the contributions this morning, I have been struck by the fact that, quite extraordinarily, the entire House, on both sides of the Chamber, has spoken with one voice. There has been total unanimity across this House during these exchanges that the proposed strikes are unreasonable, unnecessary and unfair. For the avoidance of doubt, let me tell the BMA and the resident doctors committee that this House has spoken with one voice to say: abandon this rush to strike, get around the table and work with us to rebuild resident doctors’ working conditions and to continue rebuilding our national health service. I thank the House for its support.

I thank the Secretary of State for his statement today.